Parkinsonism Relat Disord. 2013 Apr 29. pii: S1353-8020(13)00133-8. doi: 10.1016/j.parkreldis.2013.04.001. [Epub ahead of print]
Yoritaka A, Shimo Y, Takanashi M, Fukae J, Hatano T, Nakahara T, Miyamato N, Urabe T, Mori H, Hattori N.
Source
Department of Neurology, Juntendo University School of Medicine, Japan; Department of Neurology, Juntendo University Koshigaya Hospital, Japan.
Abstract
PURPOSE:
We examined the prevalence and risk of clinical symptoms in a large number of Japanese patients with Parkinson's disease (PD) (n = 1453; 650 males).
METHODS:
Events were analyzed using Kaplan-Meier survival curves, logistic regression, and Cox proportional-hazards models.
RESULTS:
The mean age (SD) was 67.7 (10.0), age of onset was 58.0 (11.5), and disease duration was 9.7 (6.6) years. The mean modified Hoehn and Yahr stage was 2.8 (1.2). Most patients (88.9%) received levodopa (547.7 (257.6) mg/day). A large proportion (81.3%) received dopamine agonists (136.2 (140.7) mg/day). About 23.4% received pain treatment 6.9 (5.1) years after the onset; females (p < 0.05) and patients with late-onset PD (≥60 years, p < 0.001) were more likely to be affected. About 44.7% of patients had wearing-off 7.5 (4.7) years after the onset, and it was more common in females (p < 0.001) and patients with early-onset PD (p < 0.001). Camptocormia was found in 9.5% of patients 8.1 (6.2) years after the onset, and it was more common in females (p < 0.05) and patients with late-onset PD (p < 0.05). About 28.6% of patients developed psychosis 9.0 (5.4) years after the onset, and it was more likely to occur in patients with late-onset PD (p < 0.001). Late-onset PD and cerebrovascular disease were also associated with increased risk of pneumonia.
CONCLUSIONS:
Considering that very few studies have assessed numerous clinical symptoms in the same report, these data provide a useful reference for the clinical course of PD.
Copyright © 2013 Elsevier Ltd. All rights reserved.
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